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2015 ; 4
(ä): 240
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English Wikipedia
Incidence and impact of interstitial lung disease and malignancy in patients with
polymyositis, dermatomyositis, and clinically amyopathic dermatomyositis: a
retrospective cohort study
#MMPMID26101728
Ikeda S
; Arita M
; Misaki K
; Mishima S
; Takaiwa T
; Nishiyama A
; Ito A
; Furuta K
; Yokoyama T
; Tokioka F
; Noyama M
; Yoshioka H
; Ishida T
Springerplus
2015[]; 4
(ä): 240
PMID26101728
show ga
The aims of this study were to retrospectively review Japanese consecutive cases
of polymyositis (PM), dermatomyositis (DM), and clinically amyopathic
dermatomyositis (CADM), focusing on interstital lung disease (ILD) and
malignancy, and to document any differences in the incidence, clinical features,
and impact on prognosis among patients with PM, DM, and CADM. We retrospectively
reviewed 62 consecutive patients diagnosed with PM, DM, and CADM according to
Bohan and Peter's criteria (PM/DM) and Sontheimer's criteria and Gerami's
criteria (CADM), focusing on ILD and malignancy. ILD occurrence rates were 48 %
(11/23) in patients with PM, 46 % (11/24) in DM, and 100 % (15/15) in CADM.
Malignancy occurred during diagnosis or the observation period in 14 patients;
86 % were without ILD, and 64 % were DM without ILD. Multivariate logistic
regression analysis showed that the risk of newly diagnosed malignancy was
significantly lower in patients with ILD [odds ratio, 0.0688; 95 % confidence
interval (CI), 0.00127-0.372; p?=?0.00190] and significantly higher in patients
with DM (odds ratio, 5.21; 95 % CI, 1.17-23.1; p?=?0.0299) than in other
patients. Patients with malignancies had shorter survival than those without
malignancies; no clinically meaningful difference in survival was observed among
the different myositis types and for presence of ILD. In CADM-ILD, 80 % fatal
cases died from refractory ILD ?90 days from the first visit; neither death nor
recurrence occurred subsequently. In conclusion, a positive association between
DM and malignancy and a negative association between ILD and malignancy were
noted. In the present study, malignancy was a predictor of poor long-term
prognosis, but ILD were not. ILD associated with CADM contributed greatly to poor
short-term prognosis, but neither death nor recurrence occurred subsequently.